Clinical picture
Zviratidzo zvemashure arteritis ndezvi:
- headache;
- kuonekwa kwemazuva mashoma (semuenzaniso, maonero maviri);
- kurasikirwa kamwe kamwe kwechiono cheziso rimwe;
- kurwadziwa kwepasara mumasana kana nzeve kana kutsvaga - kuonekwa mu50% yevarwere;
- unyoro rweganda rekona.
Anenge muine chikamu chemashure, chirwere chemazuva chinoperekedza rheumatic polymyalgia (chirwere chinoratidzwa nemarwadzo akaenzana uye kuoma kwemisungo yepafudzi nebhande rembiru). Dzimwe nguva chipatara chechirwere chacho chakashata, uye kupararira kwezviratidzo zvakadai sokuneta, kuora mwoyo, kupera kwenguva refu, kurasika kwehutano uye chido. Kutanga kufungidzirwa kwemazuva arteritis kunobatsira zvikuru kuderedza ngozi yekuva bofu. Chikonzero chekuongororwa ndeyekuti kunze kwekuongorora dhiyabhorosi nemigumisiro yeropa. Paanoongororwa, chiremba anonyanya kufunga nezvekurwadziwa kwemuviri wekare uye kuderera kana kushayikwa kwepulsation.
Kuongorora
- Kuongorora kwei oculist.
- Kuongororwa kweRopa - kazhinji anemia wekwenyoro uye kukwirira kweplatelet kunoonekwa. Chiratidzo chekucherechedza chinonyanya kukosha kuwedzera kukuru kwe ESR (sedimentation rate ye erythrocytes) kupfuura 50 ml / h. Zvisinei, mune anenge 10 muzana yevarwere, ESR inogona kuramba iri mumiganhu yakasununguka, zvichiita kuti zvive nyore kuongorora.
- Ariti mudhigiri ruzivo. Kuti kusimbise kuongororwa, zvinonzwisisika kuitisa biopsy ye temporal artery wall. Iyi nzira inoshandiswa mukukanganiswa kwechidimbu chiduku che arteri chiri pasi peganda, pasi peanesthesia yemo. Iko yakagadzirirwa biopsy specimen inoongororwa nokuda kwekuvapo kwezvokuvhiringidza kuchinja, pamwe chete nemasero makuru makuru (naizvozvo zita rokuti giant cell arteritis). Vanenge makumi maviri kubva muzana vevarwere vane rheumatic polymyalgia vane nguva yemaawa inonzi biopsy zvinokonzera zvakafanana kune zvakaonekwa nevarwere vane arteritis yenguva. Dzimwe nguva arteri biopsy inobereka chikonzero chenhema-chisingaiti, icho chingave chakavapo nekuvapo kwekusashandurwa kwemasayiti emasiti kana kutanga ne steroid therapy.
Zvimwe zvinokonzera arteritis yenguva isati yanyatsojekeswa. Pane chirevo chokuti chirwere ichi chinosanganiswa ne-pathological immune response mumasvingo emaseriyo. Inofungidzirwa kuti imwe nzira inoshandiswa pakuvandudza rheumatic polymyalgia. Kurasikirwa kwemaonero mune zvekare arteritis kunokonzerwa ne thrombosis yemidziyo yeropa retina. Kuratidzika kwekuona kutadza uye kurwadziwa mumasaya kunobatanidzwa nekudzivirira kusarura kweropa. Dhiyabhorosi inoratidza kuti zvirwere zvinotapukira zvechirwere hazviwaniki. Temporal arteritis haisi chirwere chaicho. Zvisinei, kusiyana kwemadzinza mumararamiro kunoratidza kuti chimiro chekuberekwa chinogona kuita basa mukuvandudzwa kwayo. Nenguva yemazuva arteritis yakaisvonaka masimba inochengetwa mushure memazuva maviri kana matatu ekurapa nehupamhi hwemasero e steroid. Pangozi yekurasika kurasika, dzimwe nyanzvi dzinokurudzira kutanga kutanga ne intravenous steroids. Paunenge uchishushikana nezvinetso zvekuona, kurongedza muromo we prednisolone pamusana purojekiti ya 60 mg pazuva inokurudzirwa. Nenguva yemazuva arteritis, zvinokosha kuti tisadzokorora kutanga kwekurapwa kusvikira zviitiko zvebiopsy zviwanikwa. Arterial biopsy inofanira kuitwa nokukurumidza sezvinobvira. Muvhiki yekutanga yekurapa steroid, migumisiro yake inogona kuramba yakanaka.
Nguva yakareba yekutevera
Pamatambudziko ekutanga ekurapa, chirwere che steroid zvishoma nezvishoma chinoderera kusvika pakuchengetedza zvishoma (7.5-10 mg pazuva). Izvi zvinonyanya kuderedza njodzi yemigumisiro ye steroid therapy (eg, osteoporosis kana kuderedza kusagadzirirwa zvirwere). Mune zvimwe zviitiko, zvirwere zvekudzivirira muviri (semuenzaniso, azatioprine kana methotrexate) zvinorayirwa panzvimbo ye steroid, kunyanya kune avo varwere vanobatwa zvakanyanya nekuparadzwa kwe corticosteroids. Kudzivirira kudzokorora kwechirwere ichi kunofanira kupera makore maviri.
Kuongorora kubudirira kwehutano kunoitwa:
- nguva nenguva kucherechedza kuoma kwezviratidzo;
- kudzora kwe ESR mumasimba.
Mafungiro aya anonyanya kutarisa nguva yekutanga kwemishonga. Kana zviitiko zvakakomba zvisingagoni kuonekwa, mikana yekugadzirisa zvakakwana ishoma. Kunyange zvakadaro, pakurwisana nemamiriro ekurapa, kuvandudzwa kwechikamu mune zvakaratidzwa basa kunogona kuonekwa. Kufambira mberi kwechirwere mushure mokutanga kwe steroid therapy hazvigoneki. Kuderedza chirwere chetero steroid kunogona kukonzera kudzoka kwechirwere ichi. Zvisinei, njodzi yekudzoka zvakare inoderedzwa mushure megore nehafu yekurapa, kana gore kana kupfuura mushure mokunge yapera. Kuregererwa kukanganwa kunowanzoitwa pashure pemakore maviri kubvira pakutanga kwekurapwa.
Morbidity
Temporal arteritis inowanzowedzera kune vanhu vakwegura kupfuura makore makumi mashanu. Vakadzi vanorwara kaviri kakawanda sevarume. Kuwanda kwemashure arteritis kunosiyana kubva kunyika kuenda kunyika. Pakati pevamwe, pakati pevanhu vakwegura makore makumi mashanu, chiitiko chacho chinokwana 0.49-23.3 mamiriyoni evanhu 100 000 pagore.